NPIMap

Organization Active NPI

Crescent Moon Recovery of Newport Beach

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Newport Beach, CA
National Provider Identifier
1174273106
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CRESCENT MOON RECOVERY OF NEWPORT BEACH
Practice address
1000 Quail St Ste 160
Newport Beach, CA 92660-2721
Phone
(949) 239-0911
NPI assigned
Mar 24, 2022
Last updated
Mar 24, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CRESCENT MOON RECOVERY- ORANGE COUNTY IOP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeff Evans
Title
Director of Admissions
Phone
(646) 761-9659

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary
Substance Abuse Rehabilitation Facility 324500000X NU

Addresses

Primary practice location

1000 Quail St Ste 160
Newport Beach, CA 92660-2721

Mailing address

1000 Quail St Ste 160
Newport Beach, CA 92660-2721

National Provider Directory

National Provider Directory
Tax ID family
Crescent Moon Recovery of Newport Beach6 organizations share this tax ID, including this one
Part of
Crescent Moon Recovery of Newport Beach

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1174273106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 QUAIL ST STE 160",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 QUAIL ST STE 160",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602721",
            "telephone_number": "949-239-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT MOON RECOVERY OF NEWPORT BEACH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRESCENT MOON RECOVERY- ORANGE COUNTY IOP, LLC",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "DIRECTOR OF ADMISSIONS",
        "authorized_official_telephone_number": "646-761-9659"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.